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[Secondary intraocular lens implantation: methods and complications]
J P Bellamy1, F Queguiner, N Salamé
1Service d'Ophtalmologie, Centre Hospitalier Universitaire de Besançon, Hôpital Jean Minjoz.
Purpose:
We report a review of the literature on complications of secondary lens implantation without capsular support.
Methods:
We assessed results and complications after trans-sulcus sclera l fixation (SSIOL), open-loop anterior chamber intraocular lens (ACIOL) and iris-claw lens (ICIOL).
Results:
Series published in the literature showed variable results. The rate of increased visual acuity ranged from 71% to 92% for SSIOL, 77% to 92% for ACIOL, 83% to 100% for ICIOL. Complications included: decentration and tilt of th IOL in 0-15.3% for SSIOL, 0-8.6% for ACIOL, 1.8-4.8 % for ICIOL; retinal detachment in 1.1-6% for SSIOL, 0-3.3% for ACIOL; cystoid macular edema in 5.8-23% for ACIOL, 4.8%-5.2% for ICIOL; bullous keratopathy in 0-26.3% for SSIOL, 0-14.2% for ACIOL, 4.8% for ICIOL. Vitreous hemorrhage and suture erosion were specific complications report ed for SSIOL in 1.1-25% and 15-20% of cases respectively.
Conclusion:
Secondary IOL implication is a good alternative for correction of aphakia eyes without a posterior capsule. This analysis shows no one procedures offers more safety than the others. The decisive facto r for choosing among the different types of IOL appears to be surgical experience.